FMF Certification
Tricuspid flow
Tricuspid regurgitation at 11-13 weeks’ gestation is a common finding in fetuses with trisomies 21, 18 and 13 and in those with major cardiac defects. Tricuspid regurgitation is found in about 1% of euploid fetuses, in 55% of fetuses with trisomy 21 and in one third of fetuses with trisomy 18 and trisomy 13. Inclusion of tricuspid blood flow in first-trimester combined screening improves the detection rate for trisomy 21 from about 90% to 95% for a false positive rate of 3%. Assessment of tricuspid flow need not be carried out in all pregnancies undergoing routine first-trimester combined screening. Such examination could be reserved for the 15% of the total population with an intermediate risk (between 1 in 51 and 1 in 1000) after combined testing.
Requirements for certification
Please attend all online courses through our new FMF website.
From March 2026, registration will be required to qualify for a license extension for the risk calculation software. All new licenses will be issued exclusively through the new website.
To apply for a new license or request a license extension, please follow instructions published on your original FMF Page. Please continue using your original FMF page on this website to apply for and access compatible license files via the Software section.
Note: Some countries have additional certification requirements.
USA: Visit www.fetalmedicineusa.com for accreditation instructions and contact details.
Australia: Contact RANZCOG for accreditation and image submission details.
Further updates and requirements will be posted online soon.
Protocol for images
- The gestational period must be 11 to 13 weeks and six days.
- The magnification of the image should be such that the fetal thorax occupies most of the image.
- An apical four-chamber view of the fetal heart should be obtained.
- A pulsed-wave Doppler sample volume of 2.0 to 3.0 mm should be positioned across the tricuspid valve so that the angle to the direction of flow is less than 30 degrees from the direction of the inter-ventricular septum.
- Tricuspid regurgitation is diagnosed if it is found during at least half of the systole and with a velocity of over 60 cm/s, since aortic or pulmonary arterial blood flow at this gestation can produce a maximum velocity of 50 cm/s.
- The sweep speed should be high (2-3 cm/s) so that the waveforms are widely spread for better assessment.
- The tricuspid valve could be insufficient in one or more of its three cusps, and therefore the sample volume should be placed across the valve at least three times, in an attempt to interrogate the complete valve.
Assessment of tricuspid flow
Normal tricuspid flow
Tricuspid regurgitation
